中国药物警戒 ›› 2023, Vol. 20 ›› Issue (8): 915-920.
DOI: 10.19803/j.1672-8629.20220658

• 安全与合理用药 • 上一篇    下一篇

基于FAERS对靶向HER2抗体偶联药品不良反应/事件的分析

何雄1, 马俊龙2, 阳国平2,*   

  1. 1湖南省药品审评与不良反应监测中心,湖南 长沙 410013;
    2中南大学湘雅三医院临床药理中心,湖南 长沙 410013
  • 收稿日期:2022-11-17 出版日期:2023-08-15 发布日期:2023-08-07
  • 通讯作者: *阳国平,男,博士,教授·博导,临床药理学研究。E-mail: ygp9880@126.com
  • 作者简介:何雄,女,本科,副主任药师,药品技术审评和检查。
  • 基金资助:
    湖南省科技重点专项(2020SK2010)

Adverse events caused by HER2 conjugated antibodies via FAERS

HE Xiong1, MA Junlong2, YANG Guoping2,*   

  1. 1Hunan Center for Drug Evaluation and ADR Monitoring, Changsha Hunan 410013, China;
    2Center of Clinical Pharmacology, Third Xiangya Hospital, Central South University, Changsha Hunan 410013, China
  • Received:2022-11-17 Online:2023-08-15 Published:2023-08-07

摘要: 目的 基于美国食品药品监督管理局不良事件报告系统(FAERS),对靶向HER2的抗体偶联药品T-DM1和T-DXd进行药品不良反应/事件(ADR/ADE)信号挖掘分析,为临床安全用药提供参考。方法 从FAERS提取2020年1月1日至2022年6月30日的药物ADR/ADE报告,合并去除重复报告,并对ADR/ADE信号进行筛选分析。结果 获得以T-DM1或T-DXd为首要怀疑药物的ADR/ADE报告共2 806例,筛选后得到ADR/ADE信号3 979个。对ADR/ADE信号分类发现,2种药ADR/ADE累及系统-器官分类(SOC)基本相同,T-DM1还累及生殖系统及乳腺疾病以及血管类疾病。T-DM1所关联的ADR/ADE信号强度较高的有肝肺综合征、蜘蛛痣和结节状再生性增生,T-DXd则为kL-6升高、癌性淋巴管炎和间质性肺疾病。在报告信号强度前20位的ADR/ADE中,T-DM1药品说明书中未提及的有蜘蛛痣、感觉减退和感觉异常,T-DXd有角膜炎和股骨颈骨折。结论 挖掘的真实世界ADR/ADE报告与说明书中记载一致,还报告了新的ADR/ADE,为T-DM1和T-DXd的临床使用提供参考。

关键词: 恩美曲妥珠单抗, 德喜曲妥珠单抗, 人表皮生长因子受体-2, 抗体偶联药物, 肿瘤, 乳腺癌, 美国食品药品监督管理局不良事件报告系统, 药品不良反应/事件

Abstract: Objective To provide reference for clinical drug safety by mining and analyzing adverse drug reaction/event (ADR/ADE) signals of T-DM1 and T-DXd which are antibody-conjugated drugs targeting HER2. Methods ADR/ADE reports submitted between January 1, 2020 and June 30, 2022 were retrieved from the Adverse Event Reporting System of the United States Food and Drug Administration (FAERS) before signals were screened and analyzed after removal of duplicate reports. Results A total of 2 806 ADR/ADE reports were collected with T-DM1 or T-DXd as the primary suspected drug, and 3 979 ADR/ADE signals were obtained after screening. The classification of ADR/ADE signals found that the signals of the two drugs were of a similar system organ class (SOC). However, T-DM1 was additionally involved in the reproductive system and breast disorders and vascular disorders. Furthermore, ADR/ADE signal intensities associated with T-DM1 were higher for hepatopulmonary syndrome, sideroblastic nevus and nodular aplastic hyperplasia, while T-DXd was more significantly correlated with elevated kL-6, carcinomatous lymphadenopathy and interstitial lung diseases. Among the top 20 ADR/ADE in terms of signal intensities, spider naevus, hyperalgesia and sensory abnormality were not mentioned in the instructions of T-DM1, while keratitis and femoral neck fracture were not mentioned in T-DXd instructions. Conclusion The real-world ADR/ADE mined conform with those specified in drug instructions. New ADR/ADE are also reported that can provide reference for clinical use of T-DM1 and T-DXd.

Key words: T-DM1, T-DXd, HER2, ADC, tumor, breast cancer, FAERS, ADR/ADE

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